Dubai Insurance Co.

psc, PO Box 3027, Dubai, UAE

( 100032059600003 : TRN )
RECEIPT ON BEHALF OF THE INSURANCE ‫ﺍﻳﺼﺎﻝ ﺑﺎﻟﺪﻓﻊ ﺻﺎﺩﺭ ﺑﺎﻟﻨﻴﺎﺑﺔ ﻋﻦ ﺃﻋﻀﺎء ﺍﻟﻤﺠﻤﻊ ﺍﻟﺘﺄﻣﻴﻨﻲ‬
POOL
Advance Payment of MOHRE WWP PREMIUM ‫ﺩﻓﻌﺔ ﻣﹹﺴﺪﺩﺓ ﻣﻘﺪﻣﺎ ﻟﻠﻘﺴﻂ ﺍﻟﺘﺄﻣﻴﻨﻲ ﺍﻟﺨﺎﺹ ﺑﺒﺮﻧﺎﻣﺞ ﺣﻤﺎﻳﺔ ﺍﻟﻌﺎﻣﻞ‬
(For Establishments) (‫)ﻓﺌﺔ ﺍﻟﻤﻨﺸﺂﺕ‬

TAX INVOICE 0001620660 ‫ﺍﻟﻔﺎﺗﻮﺭﺓ ﺍﻟﻀﺮﻳﺒﻴﹽﹷﺔ‬

Worker Category No ‫ﺍﻟﻌﺪﺩ‬ ‫ﻓﺌﺔ ﺍﻟﻌﺎﻣﻞ‬

Skilled 0 0.00 0 ‫ﻓﺌﺔ ﻋﺎﻣﻞ ﻣﺎﻫﺮ‬
Limited Skilled 1 180.00 1 ‫ﻓﺌﺔ ﻋﺎﻣﻞ ﻏﻴﺮ ﻣﺎﻫﺮ‬
High Risk 0 0.00 0 ‫ﻓﺌﺔ ﺍﻟﻤﻨﺸﺂﺕ ﺍﻟﻐﻴﺮ‬
Establishment ‫ﻣﻠﺘﺰﻣﺔ ﺑﺤﻤﺎﻳﺔ ﺍﻻﺟﻮﺭ‬

PREMIUM 180.00 ‫ﺍﻟﻘﺴﻂ ﺍﻟﺘﺄﻣﻴﻨﻲ‬

VAT(5% of Premium) 9.00 ‫ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ‬
(5% ‫)ﻋﻠﻰ ﺍﻟﻘﺴﻂ ﺍﻟﺘﺄﻣﻴﻨﻲ‬
AED TOTAL 189.00 ‫ﺍﻟﻤﺠﻤﻮﻉ ﺑﺎﻟﺪﺭﻫﻢ‬
PAID BY JUST OPTIC(L.L.C) BR ‫ﺩﻓﻌﺖ ﻣﻦ ﻗﺒﻞ‬
TRN:
Against of the Transaction No MB993464224AE ‫ﻋﻦ ﺍﻟﻤﻌﺎﻣﻠﺔ ﺭﻗﻢ‬
DATE: 14/09/2021 :‫ﺍﻟﺘﺎﺭﻳﺦ‬

General Information: :‫ﻣﻌﻠﻮﻣﺎﺕ ﻋﺎﻣﺔ‬

The Worker Protection Program product provides a cover ‫ﻳﻮﻓﺮ ﺍﻟﻤﻨﺘﺞ ﺍﻟﺘﺄﻣﻴﻨﻲ ﺍﻟﺨﺎﺹ ﺑﺤﻤﺎﻳﺔ ﺍﻟﻌﻤﺎﻝ ﻏﻄﺎء ﻳﻤﻜﻦ ﺍﻟﻌﻤﺎﻝ ﻣﻦ ﺍﻟﺤﺼﻮﻝ ﻋﻠﻰ‬
that enables workers to obtain their dues according to the ‫ﻣﺴﺘﺤﻘﺎﺗﻬﻢ ﻭﻓﻖ ﻻﺣﻜﺎﻡ ﻭﺷﺮﻭﻁ ﻭﺛﻴﻘﺔ ﺍﻟﺘﺎﻣﻴﻦ ﻭﺫﻟﻚ ﻓﻲ ﺣﺎﻝ ﺍﻣﺘﻨﺎﻉ ﺻﺎﺣﺐ‬
terms and conditions of the insurance policy, in the event :‫ﺍﻟﻌﻤﻞ ﻋﻦ ﺳﺪﺍﺩﻫﺎ ﻭﻓﻖ ﺍﻟﺘﻐﻄﻴﺎﺕ ﺍﻟﺘﺄﻣﻴﻨﻴﺔ ﺍﻟﺘﺎﻟﻴﺔ‬
that the employer is in default. The covered items are:

• Salaries of up to a maximum of the last 120 days prior ‫ ﻳﻮﻡ ﺍﻟﺴﺎﺑﻘﺔ ﻵﺧﺮ ﻳﻮﻡ ﻋﻤﻞ ﻟﻠﻌﺎﻣﻞ ﻓﻲ‬120 ‫ ﻭﺑﺤﺪ ﺃﻗﺼﻰ ﺃﺟﺮ ﺁﺧﺮ‬:‫• ﻷﺟﻮﺭ‬
to the last working day ‫ﺍﻟﻤﻨﺸﺂﺓ‬

• End of Service Gratuity. ‫• ﻣﻜﺎﻓﺄﺓ ﻧﻬﺎﻳﺔ ﺍﻟﺨﺪﻣﺔ‬

• Worker's Return costs. ‫• ﻧﻔﻘﺎﺕ ﻋﻮﺩﺓ ﺍﻟﻌﺎﻣﻞ‬

• Costs related to work related injuries and diseases. .‫• ﺍﻟﺘﻜﺎﻟﻴﻒ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺑﺈﺻﺎﺑﺎﺕ ﻭ ﺃﻣﺮﺍﺽ ﺍﻟﻌﻤﻞ‬

• Flight tickets for absconded workers. ‫• ﺗﺬﺍﻛﺮ ﺍﻟﺴﻔﺮ ﻟﻠﻌﻤﺎﻟﺔ ﺍﻟﻤﻨﻘﻄﻌﺔ ﻋﻦ ﺍﻟﻌﻤﻞ‬

• In the event of death, repatriation costs of the mortal .‫• ﺗﻜﺎﻟﻴﻒ ﻧﻘﻞ ﺍﻟﺠﺜﻤﺎﻥ ﻓﻲ ﺣﺎﻟﺔ ﺍﻟﻮﻓﺎﺓ‬
remains.

• All financial labor rights stipulated in Federal Law No. (8)
of 1980.
Note:
The applicant must complete the procedures with the
competent authorities, to benefit from the insurance
policy and get the Certificate of Insurance
1980 ‫( ﻟﺴﻨﺔ‬8) ‫• ﺃﻱ ﺣﻘﻮﻕ ﻋﻤﺎﻟﻴﺔ ﻣﺎﻟﻴﺔ ﻭﺍﺭﺩﺓ ﻓﻲ ﺍﻟﻘﺎﻧﻮﻥ ﺍﻻﺗﺤﺎﺩﻱ ﺭﻗﻢ‬
:‫ﻣﻼﺣﻈﺔ‬
‫ﻻ ﻳﻌﺘﺒﺮ ﻫﺬﺍ ﺍﻻﻳﺼﺎﻝ ﺑﻤﺜﺎﺑﺔ ﺷﻬﺎﺩﺓ ﺗﺄﻣﻴﻦ ﻭﻋﻠﻰ ﻣﻘﺪﻡ ﺍﻟﻄﻠﺐ ﺍﺳﺘﻜﻤﺎﻝ ﺍﻻﺟﺮﺍءﺍﺕ ﻟﺪﻯ‬
.‫ ﻟﻼﺳﺘﻔﺎﺩﺓ ﻣﻦ ﻭﺛﻴﻘﺔ ﺍﻟﺘﺄﻣﻴﻦ ﻭﺍﺳﺘﺼﺪﺍﺭ ﺷﻬﺎﺩﺓ ﺍﻟﺘﺄﻣﻴﻦ‬،‫ﺍﻟﺠﻬﺎﺕ ﺍﻟﻤﺨﺘﺼﺔ‬

This is a system generated document, does not need a signature.